Provider Demographics
NPI:1497765705
Name:SADDLER, LOUIS JAMES (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:JAMES
Last Name:SADDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 RIVER OAKS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-5324
Mailing Address - Country:US
Mailing Address - Phone:601-855-4717
Mailing Address - Fax:601-859-3451
Practice Address - Street 1:163 RIVER OAKS DR STE 201
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-5324
Practice Address - Country:US
Practice Address - Phone:601-855-4717
Practice Address - Fax:601-859-3451
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS08627207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP01383132OtherRAILROAD MEDICARE
MS00019712Medicaid
MS00019712Medicaid